Recovering from an Eating Disorder in a Society that Loves Fat Shaming (and Dieting)

Is ED recovery easier when your body is “normative or stereotypically desirable”? The anon asking the question implied that recovery could be more difficult because “an obese person … will never stop hearing hearing extremely triggering stuff about their body type.” Anon asked, “Have there been any studies on this?” Andrea tackled this question in her last post (it might be helpful to read it first if you haven’t yet); in this post, I will expand on my original answer.

Assuming anon meant, “Have there been anything studies assessing whether recovery is harder for individuals who do not fit the normative body type (because of fat phobia/fat shaming/diet culture)?” Then, my answer is: Not really, or at least I couldn’t find anything evaluating this question directly.

I was only able to find a few studies commenting on the history of overweight or obesity as a predictor of recovery/treatment … Continue reading →

Cognitive-Behavioural Therapy for Bulimia Nervosa in the “Real World”: What's the Evidence?

Cognitive-behavioural therapy (CBT) is commonly described as the evidence-based treatment for bulimia nervosa. But do the findings from nearly perfectly crafted trials, with stringently followed protocols and “ideal” participants apply to the “real world”? How generalizable are the findings from carefully selected participants to clinical populations where, for one, the prevalence of psychiatric comorbidities is relatively high?

In other words, CBT has been shown to be efficacious (i.e., it works in a controlled experimental research trial setting) but is it effective (i.e., does it work in a clinical setting where clients might have multiple diagnoses and complex needs)?

This is precisely the question that Glenn Waller and colleagues sought to answer. They wanted to see whether CBT would work in a “routine clinical setting, where none of the exclusion-and protocol-based constraints […] apply.”


Participants were recruited from a publicly-funded outpatient ED service in the UK. The only exclusion criteria … Continue reading →

Anorexia Nervosa: Can We Blame The Season Of Birth?

You might have heard that individuals born between the months of June – August (or sometimes March – August) have a higher chance of developing anorexia nervosa. But is it true? A lot of studies have been done to investigate the question of whether a season of birth (or a month) correlates with a higher risk of anorexia or bulimia nervosa. The results are inconsistent, weak, and fraught with methodological problems.

But first, how could seasons (or the average temperature during birth, or conception) have an effect on the etiology of eating disorders? What’s the hypothesis?

There seem to be two main ideas (summarized in Winje et al., 2012):

  1. alterations in neuropsychological function as a result of sunlight exposure during gestation or postpartum, maternal infections during pregnancy, or nutritional changes (seasonal variation in nutrients, vitamins)
  2. alterations in fertility/reproductive patterns of the parents due to cultural influences, disordered eating in
Continue reading →